Provider Demographics
NPI:1477720415
Name:STEPHEN E PRESSER
Entity Type:Organization
Organization Name:STEPHEN E PRESSER
Other - Org Name:ADVANCED DERMATOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUATTROCIOCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-442-4310
Mailing Address - Street 1:1815 S CLINTON AVE
Mailing Address - Street 2:SUITE 530
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5720
Mailing Address - Country:US
Mailing Address - Phone:585-442-4310
Mailing Address - Fax:
Practice Address - Street 1:1815 S CLINTON AVE
Practice Address - Street 2:SUITE 530
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5720
Practice Address - Country:US
Practice Address - Phone:585-442-4310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1492061207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10602AMedicare PIN